Healthcare Provider Details

I. General information

NPI: 1306487061
Provider Name (Legal Business Name): SILVIA NEREIDA BEDOLLA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9520 ROAD 238
TERRA BELLA CA
93270-9422
US

IV. Provider business mailing address

9520 ROAD 238
TERRA BELLA CA
93270-9422
US

V. Phone/Fax

Practice location:
  • Phone: 559-544-6815
  • Fax: 559-544-6820
Mailing address:
  • Phone: 559-791-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95012868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: